JUSTIN LARSON – Physical Therapist, NPI 1609477801

JUSTIN LARSON is a healthcare provider. based in Salt lake city, Utah. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. The NPI Number for JUSTIN LARSON is 1609477801

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
JUSTIN LARSON
NPI
1609477801
Phone
Not provided
Address
50 N MEDICAL DR
Enumeration Date
4 November 2020
Last Update Date
15 December 2021

Doctor Profile

Medical School Name
UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Secondary Phone
3606298043
Graduation Year
2020 (6 years ago)
PAC ID
7517378417
Group Practice PAC ID
7012014236
Professional Enrollment ID
I20251125004711
Address ID
WA982921911ST9612XNWXX401

Contacts

Secure Messaging
jlarson476544@direct.med.utah.edu
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness85
Years active:5State licenses:0Other namesUpdated within 12 months

1,143 PHYSICAL THERAPIST IN PRIVATE PRACTICE in UT

Provider Addresses for JUSTIN LARSON

  • 50 N MEDICAL DR

    SALT LAKE CITY, UT 841320001

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-11-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251125004711IPhysical Therapist In Private PracticeWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84132)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012014236View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeAZ
-WA
Physical Therapist In Private PracticeMN
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA

Reviews

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Frequently asked questions

Can I cross-check JUSTIN LARSON using NPI 1609477801?
NPI 1609477801 belongs to JUSTIN LARSON; compare other details if you need extra assurance.
Would JUSTIN LARSON appear as active to a payer?
You can treat JUSTIN LARSON as active for directory purposes; confirm clinical privileges separately.
How would a patient describe JUSTIN LARSON's focus?
For JUSTIN LARSON, the primary taxonomy reads as Physical Therapist. Clinical services aligned with this taxonomy classification.
Is JUSTIN LARSON located near Salt Lake City?
JUSTIN LARSON currently maps to Salt Lake City, Utah in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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